<%@page import="sy.pageModel.OrderDoctor"%>
<%@page import="sy.pageModel.Member"%>
<%@ page language="java" pageEncoding="UTF-8" contentType="text/html; charset=UTF-8"%>
<script type="text/javascript">
</script>
<div align="center">
	<form id="admin_order_doctor_editForm" method="post">
		<table class="tableForm">
		    <tr>
				<th>ID</th>
				<td>
				    <input name="id" readonly="readonly"/>
				</td>
				<th>订单号</th>
				<td><input name="orderId" readonly="readonly"/>
				</td>
			</tr>
			<tr>
				<th>卡号</th>
				<td>
				    <input name="cardId" readonly="readonly"/>
				</td>
				<th>创建时间</th>
				<td><input name="createTime" readonly="readonly"/>
				</td>
			</tr>
			<tr>
				<th>姓名</th>
				<td><input name="name" readonly="readonly"/>
				</td>
				<th>手机号</th>
				<td><input name="mobile" readonly="readonly"/>
				</td>
			</tr>
			<tr>
				<th>身份证号</th>
				<td><input name="cid" readonly="readonly"/>
				</td>
				<th>出生日期</th>
				<td><input name="bornDate" readonly="readonly"/>
				</td>
			</tr>
			<tr>
				<th>性别</th>
				<td>
				    <select name="gender" disabled>
					<%
				        for(String key : Member.MEMBER_GENDER_MAP.keySet()) {
				    %>
						<option value="<%=key%>"><%=Member.MEMBER_GENDER_MAP.get(key)%></option>
				    <%
				        }
				    %>
					</select>
				</td>
				<th>申请服务时间</th>
				<td><input name="serviceTime" readonly="readonly"/></td>
					
			</tr>
			<tr>
				<th>医疗机构</th>
				<td><input name="hospital" class="easyui-validatebox"/>
				</td>
				<th>科室</th>
				<td><input name="department" class="easyui-validatebox"/>
				</td>
			</tr>
			<tr>
				<th>紧急联系人</th>
				<td><input name="contact" class="easyui-validatebox"/>
				</td>
				<th>紧急联系人手机号</th>
				<td><input name="contactMobile" class="easyui-validatebox"/>
				</td>
			</tr>
			<tr>
				<th>紧急联系人地址</th>
				<td colspan=3><input name="address" class="easyui-validatebox" style="width:90%"/>
				</td>
			</tr>
			<tr>
				<th>服务项目</th>
				<td>
				    <input type="checkbox" name="sItem" value="助诊"   />助诊
				    <input type="checkbox" name="sItem" value="助检"   />助检
				    <input type="checkbox" name="sItem" value="助床"   />助床
				    <input type="checkbox" name="sItem" value="助疗"   />助疗
				    <input type="hidden" name="serviceItems"/>
				</td>
			</tr>
			<tr>
				<th>具体需求</th>
				<td colspan=3><textarea name="requirement" class="easyui-validatebox" style="width:90%;height:100px;"/></textarea>
				</td>
			</tr>
			<tr>
				<th>预估费用</th>
				<td><input name="estimateFee" class="easyui-numberbox" min="0" precision="2"/>
				</td>
				<th>实际费用</th>
				<td><input name="actualFee" class="easyui-numberbox" min="0" precision="2"/>
				<input name="serviceDetails" type="hidden"/>
				</td>
			</tr>
			<tr>
				<th>订单状态</th>
				<td colspan=3><input name="status" class="easyui-validatebox" type="hidden"><input name="statusName" readonly class="easyui-validatebox" style="width: 240px"></td>
			</tr>
			<tr>
			    <th>订单详情</th>
			    <td colspan=3></td>
			</tr>
			<tr>
				<td colspan=4>
				    <div id="orderDoctorDetailsEditor" style="width:99%;height:200px;"></div>
				</td>
			</tr>
		</table>
	</form>
</div>